Characterization of NT‐proBNP in a large cohort of COVID‐19 patients

Autor:	Juan R. Rey, Marcel Martinez-Cossiani, Esteban López-de-Sá, Luis Gonzalez-Valle, Luis Aliaga Martínez, Carlos Merino, Jose M Garcia-Veas, José L. Merino, Juan Caro-Codón, Lorena Martin-Polo, Laura Rodriguez-Sotelo, Card-Covid Investigators, Irene Marco, Antonio Buño, Ángel M. Iniesta, Sandra Rosillo, Sergio Castrejón-Castrejón, Alicia Herrero
Jazyk:	angličtina
Rok vydání:	2021
Předmět:	Male medicine.medical_specialty medicine.drug_class 030204 cardiovascular system & hematology 03 medical and health sciences 0302 clinical medicine Internal medicine Natriuretic Peptide Brain medicine Natriuretic peptide Humans Aged Aged 80 and over Heart Failure biology SARS-CoV-2 Proportional hazards model business.industry Hazard ratio COVID-19 Middle Aged Prognosis medicine.disease Troponin Peptide Fragments Confidence interval Pulmonary embolism Heart failure biology.protein Population study Female business Cardiology and Cardiovascular Medicine Biomarkers
Zdroj:	European Journal of Heart Failure
ISSN:	1879-0844 1388-9842
DOI:	10.1002/ejhf.2095
Popis:	AIMS: Extensive research regarding the association of troponin and prognosis in coronavirus disease 2019 (COVID-19) has been performed. However, data regarding natriuretic peptides are scarce. N-terminal pro B-type natriuretic peptide (NT-proBNP) reflects haemodynamic stress and has proven useful for risk stratification in heart failure (HF) and other conditions such as pulmonary embolism and pneumonia. We aimed to adequately characterize NT-proBNP concentrations using a large cohort of patients with COVID-19, and to investigate its association with prognosis. METHODS AND RESULTS: Consecutive patients with confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and available NT-proBNP determinations, from March 1st to April 20th, 2020 who completed at least 1-month follow-up or died, were studied. Of 3080 screened patients, a total of 396 (mean age 71.8 ± 14.6 years, 61.1% male) fulfilled all the selection criteria and were finally included, with a median follow-up of 53 (18-62) days. Of those, 192 (48.5%) presented NT-proBNP levels above the recommended cut-off for the identification of HF. However, only 47 fulfilled the clinical criteria for the diagnosis of HF. Patients with higher NT-proBNP during admission experienced more frequent bleeding, arrhythmias and HF decompensations. NT-proBNP was associated with mortality both in the whole study population and after excluding patients with HF. A multivariable Cox model confirmed that NT-proBNP was independently associated with mortality after adjusting for all relevant confounders (hazard ratio 1.28, 95% confidence interval 1.13-1.44, per logarithmic unit). CONCLUSION: NT-proBNP is frequently elevated in COVID-19. It is strongly and independently associated with mortality after adjusting for relevant confounders, including chronic HF and acute HF. Therefore, its use may improve early prognostic stratification in this condition.
Databáze:	OpenAIRE
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